Change in binge drinking behavior after Hurricane Sandy among persons exposed to the 9/11 World Trade Center disaster

The objective of this study was to examine changes in drinking behavior after Hurricane Sandy among 3199 World Trade Center Health Registry (Registry) enrollees before (2011-12) and after Hurricane Sandy (2015-16). A composite Sandy exposure scale (none, low, medium and high) included Sandy traumatic experiences, financial and other factors. Probable Sandy-related posttraumatic stress disorder (PTSD) was defined as scoring ≥44 on PTSD Checklist, and binge drinking as consuming ≥5 alcoholic drinks for men or ≥4 for women on one occasion in the past 30 days. Some of the enrollees reported binge drinking post Sandy as new binge drinkers (4.7%) or consistent binge drinkers pre- and post-Sandy (19%). Compared with non-binge drinkers pre- and post-Sandy (66.9%), the adjusted odds ratios (aOR) for being new binge drinkers and consistent binge drinkers among high Sandy exposure enrollees were 2.1 (95%CI 1.1-4.1) and 2.5 (95%CI: 1.7-3.6), respectively. High Sandy traumatic experience alone was associated with consistent binge drinking (aOR: 1.9, 95%CI: 1.4-2.6). Among enrollees without 9/11 PTSD, those with Sandy PTSD were more likely to become new binge drinkers (aOR: 4.4, 95%CI: 1.4-13.9), while Sandy PTSD was not associated with any binge drinking behavior changes among those with 9/11 PTSD. Sandy exposure, Sandy traumatic experience, and Sandy PTSD were all associated with higher binge drinking intensity. Future natural disaster response should plan for treatment to address alcohol use and PTSD simultaneously.